The great malaria debate

Malaria prevention remains one of the many challenges for doctors advising intending overseas travellers. Unfortunately, many travellers (and even their doctors) are prone to media-fed horror stories about side effects, as promulgated by their advisors and friends. This may have the effect of discouraging the use of prophylactic medication, often in areas of significant risk where it is needed. This inappropriate decision-making process is further complicated by the various quick guides available that state that malaria exists in a country, without specifying the area to be visited by the traveller. The result in this case is unnecessary prescribing, with the accompanying avoidable cost and inconvenience. This update will describe general principles aimed at restoring balance to advice about prevention of malaria.